John Carrick Kennedy, CHW

Individual provider Active NPI Community Health Worker · Vail, AZ

NPI 1023944964 · NPPES record last updated Jun 19, 2026

Key facts

NPI
1023944964
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
16974 S Rustling Leaf TRL
Vail, AZ 85641-8748
Phone
(520) 703-0064
NPI assigned
Jun 19, 2026
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Copper Star Care LLC Community Health Worker Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X AZ
Home Health Aide 374U00000X
Homemaker 376J00000X
Nurse's Aide 376K00000X AZ
Community Health Worker 172V00000X AZ Yes

Addresses

Primary practice location

16974 S Rustling Leaf TRL
Vail, AZ 85641-8748

Mailing address

16974 S Rustling Leaf TRL
Vail, AZ 85641-8748
Phone (520) 703-0064

Other providers in Vail, AZ

All providers in Vail, AZ · Community Health Worker in Arizona

Sources for this page

Verify at the official NPI Registry.